Wednesday, April 3, 2019

How Would Drug Affordability Review Boards Affect Health Insurers?


In the ongoing effort to curb rising drug costs, several states have introduced legislation that would create “drug affordability review boards” tasked with establishing a maximum amount that insurers would pay for drugs when prices rise above a set threshold.
In the eyes of the consultant who is helping states develop such measures, this approach to lowering drug costs will only benefit health insurers.
“The point is absolutely to help payers, and then they can help their enrollees” afford their prescription drugs, says Jane Horvath, a health care policy consultant and former senior policy fellow at the National Academy for State Health Policy (NASHP), which developed model legislation that the state bills are based on.
According to Horvath, the states’ bills all follow a similar formula: A board composed of five members first collects input from the public and health plans about drugs that appear to be “stressing the system,” such as new brand-name drugs with a wholesale acquisition cost of $30,000 or more per year.
Using the example of a new, pricey oncology drug with fewer side effects than an existing therapy, Horvath explains that the board then might ask health plans in the state about the net cost for the drug that the new medication is superseding. “What the health plan used to spend on the prior product maybe becomes the de facto affordability point,” she says.
For its part, America’s Health Insurance Plans (AHIP) appears somewhat supportive of the concept.
“Drug review boards at the state level can help drive transparency in how drug prices are set and why those prices are going up,” AHIP spokesperson Kristine Grow said in a statement to AIS Health. “We believe that information should then be used to find ways to increase competition and introduce new levers to negotiate lower prices.”

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